Rehabilitative efficacy of cognitive behavioral therapy-based intervention for chronic fatigue syndrome: A systematic review and meta-analysis

Cognitive behavioral therapy (CBT) has been used for chronic fatigue syndrome (CFS), but previous studies have shown inconsistencies and divergent long-term outcomes. This study aims to assess the effectiveness of CBT in improving fatigue, physical functioning, and psychological health in patients with CFS.

We searched PubMed, Web of Science, Embase, and the Cochrane Library from their inception to March 2025. Studies designed as randomized controlled trials, enrolling patients diagnosed with CFS who received CBT as a treatment intervention delivered face-to-face, in groups, or online were included. The primary outcome was the fatigue score, and the secondary outcomes were the physical function score, psychological outcomes, and adverse events. The quality of the included studies was evaluated using the Cochrane Assessment Tool for Risk of Bias Version 2 (RoB 2; The Cochrane Collaboration). Heterogeneity was detected by subgroup analysis and sensitivity analysis.